Download or read book Oral Care to Reduce Ventilator associated Pneumonia in Adult Intensive Care Patients written by Eileen Reagan and published by . This book was released on 2011 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Oral Care Intervention to Prevent Ventilator Associated Pneumonia written by Bincy Kappen and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator-associated pneumonia (VAP) is a common complication and linked to high mortality and morbidity among mechanically ventilated patients in the United States (Zurmehly, 2013). It is the second most common hospital-acquired infection that carries a 40% - 80% mortality rate (Fields, 2008). The Southwest Medical Center (SMC) is a 406-bed hospital located in Oklahoma City, Oklahoma. The VAP rate for the last six months during the year 2008 was reported as 4.3, 4.7, 0.0, 4.1, 3.9, and 0.0 respectively (Oklahoma Hospital Report, 2009). Each episode of VAP incidence can cost an average $40,000 more in healthcare expenses (Zurmehly, 2013). The proposed intervention for oral hygiene in intubated ventilated adult patients is tooth brushing three times a day and 0.12% chlorhexidine application twice a day. This mechanical and pharmacological intervention is to promote oral hygiene and thereby reduce the colonization of oropharynx and dental plaque by bacteria (Feider, Mitchell, and Bridges, 2010). The variables measured here are ventilator-associated pneumonia (VAP) rates, ventilator days, length of stay of patients in intensive care unit (ICU), length of stay of patients in hospital, frequency of tooth brushing, frequency of chlorhexidine application, oral care evaluation score, acute physiology and chronic health evaluation score, mortality rates of ventilated patients, and patient demographics. The infection-control department will keep track of the data collected during intervention and pre-intervention period. Unit directors and infection-control department will work together to evaluate the implementation process. Different strategies were used to disseminate the evidence within the organization and to the outside healthcare community.
Download or read book Comprehensive Oral Care to Prevent Ventilator Associated Pneumonia written by Mejo Vayalil and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Effective oral care is an important part of nursing care in mechanically ventilated patients in the Intensive Care Unit (ICU) (Shi and others, 2013). According to studies, Ventilator Associated Pneumonia (VAP) is one of the leading causes of death in ICUs and it occurs in 9% to 28% of patients treated with mechanical ventilation, and the percentage of mortality rates of this problem are from 24% to 50%' (Berry and others, 2007). There are many studies done to find out about the onset of VAP in mechanically ventilated patients. According to one of the studies, 'Ventilator-associated pneumonia (VAP) occurs within 24 hours of intubation and mechanical ventilation' (Stonecypher, 2010). Due to the assistive-breathing devices and the medications used to keep the mechanically ventilated patients sedated, normal defense mechanisms change, and they become more vulnerable to respiratory infection such as VAP (Pear, 2007). By implementing evidence based oral care into clinical practice, staff members can reduce the cases of VAP and also can improve the quality of care in ICUs. The purpose of this proposal is to implement a comprehensive oral care protocol in critically ill patients such as mechanically ventilated patients in ICU to reduce or prevent the incidences of VAP. Through this proposal the author will also talk about the consequences of inadequate oral care in ventilated patients. The nursing theory, which supports the writer's proposal, is Florence Nightingales environmental theory. A healthy environment is essential for the faster and better healing and recovery according to the Nightingale theory. Evidence based practices and 15 articles containing information about the importance of comprehensive oral care will also supports the author's proposal of reducing or preventing the cases of VAP in ICUs.
Download or read book Case Studies in Adult Intensive Care Medicine written by Daniele Bryden and published by Cambridge University Press. This book was released on 2017-04-20 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: This case-based approach to the intensive care medicine curriculum provides 48 case studies linking core knowledge to clinical context. Topics chosen have been mapped to eight key areas of study, making this ideal for both FFICM and EDIC exam candidates.
Download or read book Implementation of an Oral Care Protocol to Decrease Incidence of Ventilator associated Pneumonia written by Brittanie Cordova and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on documented studies, ventilator-associated pneumonia (VAP) is a leading nosocomial infection in critical care settings. In a critically ill patient, the development of VAP significantly increases their risk of mortality, length of hospital stay, and decelerates the speed of recovery. Research has shown a substantial correlation between poor oral hygiene in mechanically ventilated (MV) patients and the development of VAP. The implementation of an oral hygiene protocol and/or order-set increases nurse adherence to performing these interventions, improves quality of oral care practices, and ultimately reduces the incidence of VAP. The successful implementation of an oral care protocol requires thorough preparation. Components of implantation will include gathering of evidence, literature review, stakeholder presentation, involvement and education of intended staff, actual implementation, evaluation plan, and dissemination of evidence. The effective implementation of an oral care protocol in intensive care units for MV patients will decrease the incidence of VAP, reduce hospital stays, and decrease costs.
Download or read book Oral Hygiene with Chlorhexidine to Reduce Ventilator Associated Pneumonia written by Lisa Critchosin and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator associated pneumonia (VAP) is a nosocomial infection acquired by those patients who are mechanically ventilated for longer than 24 hours. Adherence to ventilator bundle use has proven to decrease the incidence of VAP. However, the specifics for a ventilator bundle are non-existent with only vague recommendations from the Center for Disease Control and Prevention. The oral care component of a ventilator bundle was researched to attempt to determine best oral care practices for reduction of VAP. Research evidence supports oral care twice a day with 1% chlorhexidine for significant reduction in VAP, along with a reduction of ventilator days, hospital stay, and hospital costs. This proposal includes research based evidence for implementation of this oral care practice into the intensive care unit for mechanically ventilated individuals. Key words: ventilator associated pneumonia, ventilator assisted pneumonia, oral care, chlorhexidine, ventilator bundle, intensive care unit.
Download or read book EVIDENCED BASED ORAL CARE GUID written by 崔安灡 and published by Open Dissertation Press. This book was released on 2017-01-26 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "An Evidenced-based Oral Care Guideline of Intubated Patients" by 崔安灡, On-lan, Chui, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Ventilator-associated pneumonia (VAP) is a kind of frequently hospital-acquired infection that increases morbidity and mortality in patients in intensive care units (ICU), which would in turn increase length of ICU stay, cost of hospital stay, and duration of mechanical intubation. Pneumonia appeared within 48 hours before onset of infection in people whose respiration is mechanically supported through endotracheal tube or tracheostomy is ventilator-associated pneumonia. Combating VAP is a major challenge in ICU as almost all ICU patients require mechanical intubation. Development of evidence-based methods to reduce the incidence and prevalence of VAP becomes an important issue in ICU. The objectives of this dissertation are to conduct a thorough search of current evidence on the effectiveness of using different concentration, frequency of application, method of application and amount of chlorhexidine gluconate solution for oral care of adult intubated patients in reducing VAP incidence rate. MEDLINE (OvidSP), CINAHL PLUS (EBSCOhost), PubMed and British Nursing Index were used to conduct electronic search using keywords related to VAP. A total of 99 studies were identified and seven were selected according to inclusion criteria. The quality of the seven selected studies was tested using The Scottish Intercollegiate Guidelines Network (2008) tools for randomized controlled trials, and the evidence level coding from Scottish Intercollegiate Guidelines Network was used in grading of recommendations. Six studies were rated as high quality, which oral care using chlorhexidine gluconate solution had shown statistically significant VAP incidence rate reduction or VAP-related parameters improvement. Analysis on the implementation potential, transferability of findings, feasibility of implementation and cost-benefit ratio was conducted and the oral care guideline was beneficial to intubated patients. Implementation plan, communication plan and evaluation plan about oral care guideline application was formulated. The program designed to apply the new oral care guideline would last for one year, which includes communication with stakeholders, publication of the guideline, training of staff and a one month pilot test. The primary outcome was the decrease in VAP incidence rate and the process evaluation outcome were compliance and acceptability of the guideline, satisfaction and knowledge level of staff, and hospital cost reduction. The attainment of primary outcome and process evaluation outcome would be used to evaluate the effectiveness of the program. DOI: 10.5353/th_b5088312 Subjects: Artificial respiration Intensive care nursing
Download or read book Oral Care in the Prevention of Ventilator associated Pneumonia written by Rebecca Higney and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator associated pneumonia is a highly susceptible infection that is occurring among critically ill patients who are mechanically ventilated, this can occur in adults as well as children. Ventilator associated pneumonia infection rates are as high as 28% in mechanically ventilated patients. Research shows that providing oral care on a frequent basis with the use of an antiseptic solution such as Chlorhexidine, will reduce the rate of ventilator associated pneumonia among vented patients as well as decrease mortality rates and decrease the length of a patient's hospital stay. Current policies for oral care already exist but this proposal will include an implementation plan for making sure staff is properly educated and are incorporating the appropriate oral care policies and techniques for mechanically ventilated patients. Ventilator associated pneumonia is impacting healthcare profoundly and will begin to affect hospital reimbursement rates. Prevention of this infection needs to be a team effort involving everyone who comes into contact with vented patients, however nurses will be on the from lines of prevention. Ventilator associated pneumonia in an infection that can be prevented.
Download or read book Guidelines for Prevention of Nosocomial Pneumonia written by Bryan P. Simmons and published by . This book was released on 1982 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Surgical Intensive Care Medicine written by John M. O'Donnell and published by Springer Science & Business Media. This book was released on 2009-11-18 with total page 711 pages. Available in PDF, EPUB and Kindle. Book excerpt: We are honored to present the second edition of Surgical Intensive Care Medicine. Our first edition was considered to be an important contribution to the critical care literature and received excellent reviews from Critical Care Medicine, Chest, and Anesthesiology. In the second edition, the basic organization of the book remains unchanged, being composed of 60 carefully selected chapters divided into 11 sections. The book begins with general topics in primary intensive care, such as airway management and vascular cannulation, followed by categories based on medical and surgical subspecialties. While the chapters discuss definitions, pathophysiology, clinical course, complications, and prognosis, the primary emphasis is devoted to patient management. The contents of the current edition have been comprehensively upgraded and the chapters retained from the first edition have been thoroughly updated, revised, or rewritten. In this second edition, some new topics have been added including Postoperative Care of the Obese Patient, Postoperative Care of the Pancreas Transplant Patient, Optimization of High-Risk Surgical Patients, Post- erative Alcohol Withdrawal Syndrome, Ethics and End of Life Issues, Improving the ICU, and Continuous Medical Education in Intensive Care Medicine. We are extremely fortunate to have high-quality contributors, many of whom are nationally and internationally recognized researchers, speakers, and practitioners in Cri- cal Care Medicine. An important feature of this latest edition is the geographical diversity of its authors. Most are based in the United States, but colleagues from Canada, England, Ireland, Germany, Belgium, Holland, France, Italy, Portugal, and Australia have also made notable contributions.
Download or read book Significance of Specialized Education on Nurses Compliance Rate with Oral Care Protocol for Mechanically Ventilated Patients in Adult Intensive Care Unit written by Marharyta Dulevich and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Varieties of documented studies suggest the oral care protocol for mechanically ventilated patients significantly decrease rate of ventilator-associated pneumonia in adult population. Nevertheless, practice reveals a lack of specialized education in regards of oral care protocol and as a result- unsatisfactory compliance rate among nurses involved in care of mechanically ventilated patients. Oral care instructions and follow-up actions have been proved its effectiveness and efficiency. Meanwhile, high oral care compliance rate is associated with better patients' outcomes, shorter intensive care unit stay and hospitalization, lower mortality rate, and financial benefit for a hospital. Implementing specialized education for critical care nurses with systematic follow-up actions can increase the compliance rate with all mentioned above positive outcomes. This project is focused on comprehensive literature review, clinical observation of current practices and policies, and proposal of improvement actions.
Download or read book Selective Decontamination of the Digestive Tract SDD written by Hans Rommes and published by Springer Nature. This book was released on 2021-03-08 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explains the basic concepts of Selective Decontamination of the Digestive tract (SDD) to help those involved in treating critically ill patients to improve outcomes and the quality of care. SDD has led to major changes in our understanding, the treatment and prevention of infections in critically ill patients over the past 40 years. It is the most studied intervention in intensive care medicine and is the subject of 73 randomized controlled trials, including over 15000 patients and 15 meta-analyses. SDD reduces morbidity and mortality, is cost-effective and safe as SDD does not increase antimicrobial resistance. Correct application of the SDD strategy enables ICU teams to control infections – even in ICUs with endemic antibiotic resistant microorganisms such as methicillin resistant S. aureus (MRSA). Describing the concept and application of SDD, and presenting case studies and microbiological flow charts, this practical guide will appeal to intensivists, critical care practitioners, junior doctors, microbiologists and ICU-nurses as well as infection control specialists and pharmacists.
Download or read book Prevention of Ventilator associated Pneumonia written by Robyn Prather and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator-Associated pneumonia (VAP) is defined as a Hospital Acquired Infection (HAI) that develops in patients who have been ventilated for more than 48 hours and who were not diagnosed with a pneumonia when intubated. VAP is associated with increased mortality, morbidity, lengths of stay, and increased cost of care. It is the leading cause of death of all hospital acquired infections carrying a mortality rate of 46%. VAP also plays a role in 30% of additional deaths of these critically ill patients due to hospital system failures that could have been avoided. Studies have shown that by implementing evidence based best practices called the VAP bundle on all ventilated patients the incidence of VAP may be decreased up to 45% (safer healthcare now, 2012). While oral care is a component of the VAP bundle, more study is needed regarding best practices for this care component. Current research indicates that a high level of compliance to a scheduled oral care regiment using an antimicrobial solution of 0.12% Chlorhexidine results in the greatest reduction in oral bio-burden (Bopp, Darby, Loftin, and Broscious, 2006). The objective of this study is to test this intervention in reducing bacterial load in the oral cavity and to support the intervention through increased staff compliance to the proposed oral care regimen. Data will be gathered and analyzed to better identify causative factors to VAP, and to monitor compliance to the proposed oral care protocol. The target group for intervention will be all adult patients admitted to the Intensive Care Unit (ICU). The target group for compliance will be all clinical staff in the ICU. The project will take place over a one year period and will include education, training, the oral care protocol, data collection, and reporting results to both clinicians and stakeholders. Expected results are increased staff compliance greater than 90% and a reduction in VAP of 50% at the end of the study.
Download or read book The Relationship of Oral Care Routines and Ventilator Associated Pneumonia in Mechanically Ventilated Pediatric Critical Care Patients written by Ambre' L. Huff and published by . This book was released on 2007 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: Key Words. oral care, mechanically ventilated, ventilator associated pneumonia.
Download or read book Oral Biofilms written by S. Eick and published by Karger Medical and Scientific Publishers. This book was released on 2020-12-21 with total page 247 pages. Available in PDF, EPUB and Kindle. Book excerpt: Biofilms are highly organized polymicrobial communities that are embedded in an extracellular matrix and formed on natural and artificial surfaces. In the oral cavity, biofilms are formed not only on natural teeth, but also on restorative materials, prosthetic constructions, and dental implants. Oral diseases like caries, gingivitis, periodontitis, and also pulp inflammation are associated with biofilms. This publication is an up-to-date overview on oral biofilms from different clinically relevant perspectives. Experts comprising basic researchers and clinicians report on recent research relating to biofilms - from general summaries to recommendations for daily clinical work. This book covers all aspects of oral biofilms, including models used in the laboratory, biofilms in dental water unit lines, periodontal and peri-implant biofilms, caries-related biofilms, halitosis, endodontic biofilms, and Candida infections, as well as biofilms on dental materials and on orthodontic appliances. Several chapters deal with anti-biofilm therapy, from the efficacy of mechanical methods and the use of antimicrobials, to alternative concepts. This publication is particularly recommended to dental medicine students, practitioners, other oral healthcare professionals, and scientists with an interest in translational research on biofilms.
Download or read book Multidisciplinary Team Approach to Prevent Ventilator Associated Pneumonia written by Suzanne B. Breedlove and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventilator- associated pneumonia (VAP) exist as a major source of morbidity, mortality, and expense with an estimated economic impact of a sole instance of VAP reaching from $11,897 to $15,0841 in the intensive care unit (ICU), even with therapies directed against it (Garcia, et.al, 2009). It is the second most common hospital acquired infection in the United States according to Sedwick, Lance-Smith, Reeder, and Nardi, (2012), and is responsible for one fourth of the infections in the ICU despite the development of VAP bundles. The Center for Medicare and Medicaid Services (CMS) recently listed VAP as one of the reasonably preventable diseases, along with other hospital acquired infections (HAIs) and soon hospitals may lose reimbursement for the care provided to these patients. An article by Arroliga et. al, (2012) reports on a study involving a multidisciplinary team of practitioners; an intensivist (physician), registered nurse (RN), respiratory therapist (RT), and infection control practitioner, participating on a task force with an objective of reducing VAP. The research involved the respiratory therapist completing the mouth care portion of the ventilator associated pneumonia (VAP) bundle, instead of the nurse, with a dramatic improvement in their mouth care compliance. However, a stronger foundation was seen throughout the literature the multidisciplinary team. Defeating ventilator-associated pneumonia requires more than just bundle compliance; it is a complex disease requiring a multifaceted team. This proposed solution involves the implementation of a multidisciplinary team; including the co-management team (nurse unit manager and the physician champion), clinical educator, a statistician (quality and compliance representative) respiratory therapist, pharmacist, and project co-coordinator. This team will be entrusted with the responsibility to evaluate current practices and coordinate new ones. The findings of this study not only reflects on improving patient outcomes related to oral care compliance on ventilator A MULTIDISCIPLINARY TEAM 3 associated pneumonia in an adult intensive care unit but the role of the multidisciplinary team; where nurses, respiratory therapists, physicians, and administrators come together, in a novel way to attack problems that are unsolvable by only one department. Then again, if the ideas and efforts of several departments, all of which are focused on the same problem, are synthesized, a synergistic effect can be achieved, and selected goals are more likely to be accomplished (Kaye et.al, 2000)). Key to this multidisciplinary team approach is clear access to hospital management and a culture change where everyone becomes a key stakeholder in the process.
Download or read book Ventilator associated pneumonia program in reducing ventilator associated pneumonia VAP in adult intensive care units in a tertiary hospital in Manila written by Lina Vince Cruz De Castro and published by . This book was released on 2011 with total page 147 pages. Available in PDF, EPUB and Kindle. Book excerpt: Critically-ill patients hooked on ventilator have a significant risk of developing VAP, in which the mortality is high. Thus, the researcher wanted to test whether a program to prevent and reduce VAP would be effective. The researcher utilized a pre and post study design. Pre-study level of compliance among healthcare workers in terms of hand hygiene, head of bed elevation, oral care and breathing circuit management as well as VAP incident of patients on ventilator were compared with the post study levels after the initiation of a VAP program. Using Microsoft excel and Stata Special Edition 10, the study revealed a significant increased in the compliance rate among helthcare workers (hand hygiene: pre 35.6%, post 66.3%; head of bed elevation: pre 88.3%, post 96.8%, oral care: pre 61.9%, post 90.4%; breathing circuit management: pre 66.7%, post 93.8%) after the implementation of the VAP Program resulting to a significant lower VAP incident rate among ventilated patients (n=300) in the post-intervention than in the pre-intervention stage (2.6 versus 22.2 VAP per 1000 ventilator days). Hence, implementation of the VAP Program in the adult intensive care units was associated with significant decline in the ventilator-associated pneumonia (VAP) incident rate.
